What is tennis elbow?

Lateral epicondylitis, commonly known as tennis elbow, is swelling of the tendons that bend your wrist backward away from your palm.

A tendon is a tough cord of tissue that connects muscles to bones. The tendon most likely involved in tennis elbow is called the extensor carpi radialis brevis. Tennis elbow is usually diagnosed in both men and women between the ages of 30 to 50 years.

What causes tennis elbow?

Tennis elbow, as the name implies, is often caused by the force of the tennis racket hitting balls in the backhand position. Your forearm muscles, which attach to the outside of your elbow, may become sore from excessive strain. When making a backhand stroke in tennis, the tendons that roll over the end of our elbow can become damaged. Tennis elbow may be caused by:

• Improper backhand stroke
• Weak shoulder and wrist muscles
• Using a tennis racket that is too tightly strung or too short
• Other racquet sports, like racquetball or squash
• Hitting the ball off center on the racket, or hitting heavy, wet balls

However, many people who suffer from tennis elbow do not play tennis. The problem can be caused by any repetitive movement. Other causes of tennis elbow include:

• Painting with a brush or roller
• Operating a chain saw
• Frequent use of other hand tools on a regular basis
• Using repeated hand motions in various professions, such as meat cutters, musicians, dentists, and carpenters

What are the symptoms of tennis elbow?

The following are the most common symptoms of tennis elbow. However, you may experience symptoms differently.

At first, you may have pain, burning, or an ache along the outside of your forearm and elbow. With time, the pain gets worse. If you continue the activity that caused your condition, the pain may spread down to your wrist, even at rest. Pain may also persist when you place your arm and hand palm-down on a table, and then try to raise your hand against resistance. You may also feel pain when you try to lift and grip small objects, such as a coffee cup. A weak grip is another symptom of tennis elbow.

The symptoms of tennis elbow may resemble other medical problems or conditions. Always see your health care provider for a diagnosis.

How is tennis elbow diagnosed?

Your health care provider can usually diagnosis your tennis elbow by a physical exam. In some cases, you may certain tests, such as:

• An X-ray to look at the bones of your elbow to see if you have arthritis in your elbow.
• Magnetic resonance imaging (MRI) can show your tendons and how severe the damage is. An MRI of your neck can show if arthritis in your neck, or disk problems in your spine are causing your arm pain.
•  Electromyography (EMG) of your elbow may show if you have any nerve problems that may be causing your pain.

How is tennis elbow treated?

It’s important to avoid the movement that caused your injury in the first place. Treatment may include:

• Rest and stopping the activity that produces the symptoms
• Ice packs (to reduce inflammation)
• Strengthening and stretching exercises
• Anti-inflammatory medications (such as ibuprofen or naproxen)

If these treatments do not work, your health care provider may talk to you about:

• Bracing the area to keep it still for a few weeks
• Steroid injections to help reduce swelling and pain
• A special type of ultrasound that can help break up scar tissue, increase blood flow, and promote healing
• Surgery (rarely necessary)

What can I do to prevent tennis elbow?

• Keep your arms flexible and strong
• Avoid repetitive movements
• Warm up before exercising or using your arms for sports or other repetitive movements
• If you play a racquet sport, make sure your equipment is right for you

When should I call my health care provider?

• If  pain or trouble moving affects your regular daily activities
• If your pain doesn’t get better, or it gets worse with treatment
• You see a bulge or lump on your arm

Key points

• Lateral epicondylitis, or tennis elbow, is swelling or tearing of the tendons that bend your wrist backward away from your palm.
• It’s caused by repetitive motion of the forearm muscles, which attach to the outside of your elbow. The muscles and tendons become sore from excessive strain.
• Symptoms include pain, burning, or an ache along the outside of the forearm and elbow. It gets worse and may spread down to the wrist if the person continues the activity that causes the condition. The grip may become weak.
• Lateral epicondylitis is diagnosed by an examination of the elbow joint. The doctor may need an X-ray or MRI to see what’s causing the problem. An EMG may be done to look for nerve problems.
• Lateral epicondylitis can be treated with rest and medicines to help with the inflammation. Exercises often help too. Rarely, surgery may be done to repair the tendon.
• You can help prevent lateral epicondylitis by doing things like warming up before exercise or sports, increasing activity slowly, using the right equipment for activities, and strengthening your arm muscles.
• Follow your health care provider’s recommendations to get rest and manage pain and swelling. Let your health care provider know if these strategies don’t help reduce pain, swelling, and loss of function.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.